Bottom line

Average change Mean improvement was 21.8 points on NEI-VFQ-14 and 19.3 points on NEI-VFQ-25, two patient-reported visual-function measures.

Cataract surgery generally improves more than chart acuity. Patients report easier reading, mobility and independent activity. The direction of benefit was consistent overall, but its size differed greatly between studies.

What the review included

The review included 122 studies: 47 prospective cohorts, nine randomized trials and 38 case series. Meta-analysis pooled 56 NEI-VFQ-14 cohorts and 33 NEI-VFQ-25 cohorts. About half of the studies had moderate risk of bias.

Why the pooled number needs caution

  • Heterogeneity reached I² 99.9% for NEI-VFQ-14 and 99.4% for NEI-VFQ-25.
  • The NEI-VFQ-14 prediction interval ranged from −11.3 to 54.9 points.
  • Small-study effects were detected for NEI-VFQ-25; adjustment reduced the estimate from 19.3 to 18.2 points.

Patient-reported outcome measures therefore complement acuity but cannot provide a universal forecast. Comparisons between services need the same questionnaires, time points and scoring rules.

Limitations

Populations, procedures, follow-up and questionnaire versions varied. Most evidence was observational and compared scores before and after surgery. The review supports an overall benefit but cannot identify the best surgical technique or IOL.